Job Summary
The Denial Coding Supervisor provides subject matter expertise in physician medical coding, insurance billing, and follow-up activities. This position oversees the Physician Billing (PB) Denial Coders and Appeals and Denial Coordinators, ensuring the accuracy and efficiency of denial management processes. The supervisor is responsible for implementing and maintaining policies, programs, and system enhancements to improve the financial and operational performance of the unit. This role ensures adherence to standard work and Lean Thinking principles to optimize processes and outcomes.
Mission Statement
Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.
Responsibilities*
Leadership
- Committed to the growth and development of team members by providing guidance, encouragement, and opportunities for learning and professional grLeadership
- Committed to the growth and development of team members by providing guidance, encouragement, and opportunities for learning and professional growth
- Advocate for continuous improvement by encouraging team members to identify inefficiencies and suggest solutions
- Encourages transparency and active listening to promote team collaboration
- Creates an inclusive environment by understanding and valuing team members? perspectives and experiences. Builds trust and enhances team engagement through supportive leadership
- Ability to convey expectations clearly and promote open communication through effective verbal and written communication
- Skilled in analyzing staff challenges, identifying root causes, and implementing actionable solutions. Demonstrates creativity and resourcefulness in overcoming obstacles and barriers
- Capable of making timely, well-informed decisions while balancing organizational, departmental, and team needs
- Takes accountability for outcomes and adapts decisions as necessary.
- Effectively mediates conflicts by identifying underlying issues, facilitating open communication, and providing guidance toward a resolution by addressing concerns constructively and productively
- Ability to make timely and informed decisions balancing team needs with organizational goals
Operations
- Participate and provide expert knowledge in physician medical coding, insurance billing, and follow-up activities.
- Monitor and report productivity of denial coders and appeals and denial coordinators
- Monitor daily progress of accounts receivables
- Participate in the implementation and maintenance of policies, programs, and system enhancements to improve the financial and operational performance of the unit.
- Employ lean principles to eliminate waste and increase value.
- Interview, select and train employees.
- Create work schedules.
- Plan and direct work.
- Appraise productivity and quality for the purpose of performance evaluations and merit increases.
- Handle staff complaints and grievances and discipline when necessary.
- Hire and terminate employees.
- Read and interpret accounts receivable metrics to assign and prioritize duties.
- Monitor changes in laws, regulations, and policies that impact coding and reimbursement and assure compliance with coding procedures and workflows.
- Supervisor may spend time performing many of the same duties as subordinates.
- Partners in developing strategy to address high-risk coding practices, recommendations for corrective action plans or process improvements and creates policies, procedures, and internal controls which reinforce the highest level of standard of coding quality goals and outcomes
- Collaborate with Manager and Medical Coding Compliance Specialists to review training materials for staff and to support coding quality and education initiatives
- Ensures the collaboration required between the Clinical Documentation Specialists and Coding functions is optimal to achieve complete and clear documentation
Competencies
- Extensive knowledge of federal, state, and payer-specific regulations and policies pertaining to documentation, coding, and billing
- Experience with 3M Computer Assisted Coding system
- Excellent verbal and written communication skills, analytical thinking, and problem-solving skills with attention to detail are required
- Proficiency in organizational skills and planning with an ability to juggle multiple priorities in a fast-changing environment
- Ability to navigate the EHR to identify documents for review to provide accurate capture of clinical information
- Complies with all aspects of coding, abides by all ethical standards, and adheres to official coding guidelines
- Ability to work independently as well as with a diverse group of people in a diplomatic and effective manner
- Strong customer focus and the knowledge and skill to identify, meet and evaluate customer expectations
- Strong presentation skills
- Exceptional ability to lead, manage, and mentor staff through complex work redesign efforts.
- Logical, analytical, and organized with the ability to reprioritize quickly and efficiently
- Knowledge and understanding of third-party payer, regulatory and accreditation requirements
- Excellent collaboration, meeting facilitation, presentation, and communication skills
- Exceptional analytical and problem-solving ability, organizational skills, and attention to detail
- Ability to work in a fast-paced environment under multiple pressures and deadlines
- Excellent verbal and written communication skills up, down, and across the organization
- Considerable experience with Windows computer environment and proficiency with Microsoft 365 software:
- Word
- PowerPoint
- Teams
- SharePoint
- Ability to work independently, self-motivated and an ability to adapt to the changing healthcare environment
Required Qualifications*
- An Associate?s degree in Health Information Management or an equivalent combination of education and experience
- Certified Professional Coder (CPC), Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS) credentials is required
- Minimum of 2 years of experience in medical coding, billing, and accounts receivable denial management
- Coding knowledge with a strong understanding of the CPT and ICD-10-CM Professional Guidelines application
Modes of Work
Hybrid - the work requirements allow both onsite and offsite work and an employee has an expected recurring onsite presence. On occasion, the employee may be required and must be available to work onsite more frequently if necessitated by unit leadership
Positions that are eligible for hybrid or mobile/remote work mode are at the discretion of the hiring department. Work agreements are reviewed annually at a minimum and are subject to change at any time, and for any reason, throughout the course of employment. Learn more about the work modes.
Background Screening
Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.
Application Deadline
Job openings are posted for a minimum of seven calendar days. The review and selection process may begin as early as the eighth day after posting. This opening may be removed from posting boards and filled anytime after the minimum posting period has ended.
U-M EEO/AA Statement
The University of Michigan is an equal opportunity/affirmative action employer.